Provider Demographics
NPI:1811392863
Name:BAILEY, MELISSA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:BOUMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:6905 S 36TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68147-1231
Mailing Address - Country:US
Mailing Address - Phone:402-734-7592
Mailing Address - Fax:
Practice Address - Street 1:6905 S 36TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68147-1231
Practice Address - Country:US
Practice Address - Phone:402-734-7592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-01
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22273183500000X
NE14637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist